Pacemaker patients in Malta are among the first in Europe to benefit from an antibacterial envelope, a special pouch that shrouds a pacemaker and radically slashes the risk of deadly infection.
Cardiologist Robert Xuereb told Times of Malta that since it was introduced a few weeks ago, seven patients have already had it fitted.
There are three types of pacemaker: single, dual and triple-chambered. Triple-chamber pacemakers are used in the worst cases and are typically reserved for patients with congestive heart failure.
The antibacterial envelope, which costs around €1,200, will only be used in procedures involving a triple -chamber pacemaker or an implantable cardioverter defibrillator (ICD), which is a small device that uses electrical pulses or shocks to help prevent sudden cardiac arrest.
The envelope is composed of a mesh coated in a special gel containing two types of antibiotics. The pacemaker or ICD slides into the envelope and the antibiotics are slowly absorbed by the body within a span of two weeks.
We are facing an epidemic in Malta
Dr Xuereb explained that various studies have shown it to slash the risk of heart infection by 70 to 90 per cent. The new technology has been used in the US and Canada for the past two years but it was only a few weeks ago that the product was given the CE marking, enabling it to be used in the European Economic Area.
“Malta, like the rest of the world, is facing an upsurge of these infections as they become more resistant to medication.
“Over the past two years, we’ve treated eight infected patients. Such infections are extremely expensive to treat.
“They cause a lot of hardship for the patient, who has to spend many long weeks in hospital and in a lot of pain.
“The whole pacemaker system would need to be extracted and replaced with a new one. Triple-chamber pacemakers cost between €15,000 and €20,000.
“In the past, an infected patient would need to be flown to Pisa – it’s only in the past few months that we’ve been treating them at Mater Dei, with the help of a foreign expert. So in reality, the antibacterial envelope is very cost-effective.”
Infection sets in during implantation or when a pacemaker’s battery is replaced every eight years.
It generally manifests itself within two or three weeks following implantation but can sometimes lie dormant and resurface two to three years later.
Between August 2013 and August 2014, 490 patients have been fitted with single, dual or triple-chamber pacemakers.
Cardiovascular disease is the number one killer in Malta.
“We are facing an epidemic in Malta because unfortunately, the four big risks that lead to cardiovascular disease are all very common: smoking, diabetes, high blood pressure and high cholesterol.
“We can prevent heart problems by exercising for 30 minutes four times a week, eating healthily by avoiding fatty foods and large quantities, quitting smoking and regularly checking blood pressure and cholesterol levels and controlling them if high.”